What Clinical and Laboratory Parameters Distinguish Between Acute and Chronic Renal Failure?

Introduction: In developing countries, a large number of patients presenting acutely in renal failure are indeed cases of advanced chronic renal failure. In this study, we compared clinical and laboratory parameters between patients with acute renal failure (ARF) and chronic renal failure (CRF), to identify discriminatory features. Patients and methods: The Renal Unit of Obafemi Awolowo University Teaching Hospitals Complex is a major referral center for renal disease in Nigeria. 20 patients with ARF and 22 patients with CRF (who had not had dialysis intervention) were recruited for the study at presentation. They had full evaluation including demography, history of duration of symptoms, blood pressure, volume of urine, and laboratory parameters: serum creatinine, urea, potassium, and packed cell volume (PCV). These parameters were compared using Mann Whitney U test for nonparametric data to determine statistical significance. Results: There were no significant differences between the two groups regarding their (i) ages (ii) serum creatinine and (iii) PCV. In contrast, statistically significant differences were obtained for (i) the mean duration of symptoms, which was longer in CRF patients, (ii) the mean 24 hour urine volume, which was larger in CRF patients, (iii) the mean systolic and diastolic blood pressures, both being significantly higher in CRF patients, (iv) and the mean serum urea level, which was higher in ARF patients. Conclusion: It is concluded that the duration of symptoms, quantity of urine, blood pressure, and serum urea levels are distinguishing parameters between ARF and CRF, while serum creatinine and PCV are not. Key words: Acute Renal Failure, Chronic Renal Failure, Laboratory Parameter

Comparative Evaluation of Antioxidant Properties of Methanol Extracts of Allium cepa bulb, Allium cepa bulb peels and Allium fistulosum.

Medicinal plants have protective effects against many physiological diseases because of their phytochemical components which are better antioxidants. This study was aimed at comparing the in vitro antioxidant activity, phenolic and flavonoid content of the methanol extracts of Allium cepa bulb, Allium cepa bulb peel and Allium fistulosum. The antioxidant activity was determined by 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, ferric reducing antioxidant power (FRAP), iron chelating activity and molybdate ion reduction assays. The total flavonoid and total phenolic content (TPC) were carried out using aluminium chloride and Folin-Ciocalteu assay respectively. The results showed that A. cepa bulb peel has the highest phenolic content and the antioxidant activity while the A. fistulosum showed the least. Furthermore, the total flavonoid content and metal iron chelating activity was highest in A. cepa bulb, while lowest values were obtained in A. fistulosum and A. cepa bulb peel respectively. The results suggest that the A. cepa bulb peel, A. cepa bulb and A. fistulosum extracts can be used as sources of natural antioxidants. However, A. cepa bulb peel may be the most potent

CONTRIBUTIONS OF THE FADAMA II PROJECT TO AQUACULTURE DEVELOPMENT IN OGUN STATE, NIGERIA

The National Fadama Development Project (FADAMA II) was an idea conceived by the World Bank, Africa Development Bank and Federal Government with active involvements of the State and Local governments as quick and sustainable agriculture and rural development strategy targeted at dry sea- son farming activities and related agro–processing and marketing. This study was carried out to as- sess the contributions of Fadama II project to aquaculture development in Ogun State, Nigeria. 120 fish farmers were selected using multi-stage sampling techniques and structured, pre-tested and vali- dated interview guides to elicit information from fish farmers. The data collected were analyzed using descriptive and inferential statistics. The study revealed that majority of the respondents were male (60.8%), married (84.2%), cultured Clarias spp. only (62.5%) and also had large household sizes (63.3%), secondary education (44.2%), source of aquaculture messages was mainly from telephone (GSM-66.7%) and extension guides/bulletins (75.8%), and generated large annual fisheries’ income from Fadama aquaculture (65.8%). Fadama II project had contributed positively to acquisition of pro- ductive asset, poverty reduction, increased income, rural infrastructure, provision of input supports, project management, reduced fish culture period, increase in overall fish yield, expansion of fishery business, improvement in livelihood, and demand-responsive advisory services. The results also showed that majority of the fish farmers considered both lack of finance and high cost/lack of construc- 2 tion equipment as serious factors affecting their fish farming. The results of Chi-square analysis (X ) revealed that there was a significant relationship between the Fadama II project and aquaculture de- velopment in provision of Pilot Assets Acquisition Support (X2 = 52.050; P<0.05). Based on the find- ings, it was recommended that more Fadama facilitators should be employed to provide technical knowledge to fish farmers on how to use some equipment and on how to improve their fish farming business and productivity

Exchange Rate Management and Sectoral Output Performance

The aim of all national economies is to stabilize its exchange rate with the countries it trades with; therefore exchange rate is very vital to the economy of every country. Nigeria has adopted both fixed and fluctuating exchange rate regimes in order to realize the goal of a stable exchange rate but this has proven futile as the economy has continued to perform poorly over the years. This study is therefore aimed at examining the effect exchange rate management has on output performance of both the agricultural and the manufacturing sector. Secondary data from 1981 – 2015 were analyzed using the Ordinary Least Square technique. The findings revealed that exchange rate have a positive and significant effect on only the agriculture sector. The study recommends amongst others that efforts should be made to increase the exportation of agricultural products in order to boost exchange rate

A renal registry for Africa: first steps.

There is a dearth of data on end-stage renal disease (ESRD) in Africa. Several national renal registries have been established but have not been sustainable because of resource limitations. The African Association of Nephrology (AFRAN) and the African Paediatric Nephrology Association (AFPNA) recognize the importance of good registry data and plan to establish an African Renal Registry. This article reviews the elements needed for a successful renal registry and gives an overview of renal registries in developed and developing countries, with the emphasis on Africa. It then discusses the proposed African Renal Registry and the first steps towards its implementation. A registry requires a clear purpose, and agreement on inclusion and exclusion criteria, the dataset and the data dictionary. Ethical issues, data ownership and access, the dissemination of findings and funding must all be considered. Well-documented processes should guide data collection and ensure data quality. The ERA-EDTA Registry is the world's oldest renal registry. In Africa, registry data have been published mainly by North African countries, starting with Egypt and Tunisia in 1975. However, in recent years no African country has regularly reported national registry data. A shared renal registry would provide participating countries with a reliable technology platform and a common data dictionary to facilitate joint analyses and comparisons. In March 2015, AFRAN organized a registry workshop for African nephrologists and then took the decision to establish, for the first time, an African Renal Registry. In conclusion, African nephrologists have decided to establish a continental renal registry. This initiative could make a substantial impact on the practice of nephrology and the provision of services for adults and children with ESRD in many African countries

Poverty and trade liberalization: empirical evidence from 21 African countries

The study investigated the possible nexus between trade liberalization and poverty in 21 African countries covering the period 2005–2014. The study deployed the following econometric tests: descriptive statistics; the correlation matrix and variance inflator; the panel unit root test; the pooled OLS technique; and the panel co-integration test (Johansen co-integration test). In order to confirm the robustness and validity of the regression model result, Ramsey RESET, cross dependence, autocorrelation and heteroscedasticity tests were conducted. The findings reveal that foreign direct investment and inflation rate had a positive relationship with the human development index while exchange rates and trade openness were negatively related to poverty level at the 5 percent level. The study recommended urgent policy measures aimed at revamping the poverty alleviation programmes. The study recommended that in a bid to diversify export market, developing countries should target other developing countries in the spirit of South–South cooperation. Such countries should also consider the joining or strengthening of regional economic integration. Incentives for production and human capacity building in the export-oriented sector should be emplaced. Social and economic policies are required to protect any country against the adverse effects of lowered trade barriers

Prevalence of chronic kidney disease among people living with HIV/AIDS in Burundi: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Since little is known about chronic kidney disease (CKD) among people living with HIV/AIDS (PLWHA) in Sub-Saharan Africa, the prevalence and nature of CKD were assessed in Burundi through a multicenter cross-sectional study.</p> <p>Methods</p> <p>Patients underwent assessments at baseline and 3 months later. Glomerular Filtration Rate (GFR) was estimated using abbreviated 4-variable Modification of Diet in Renal Diseases (MDRD) and Cockroft-Gault estimation methods. Patients were classified at month 3 into various CKD stages using the National Kidney Foundation (NKF) definition, which combines GFR and urinary abnormalities. Risk factors for presence of proteinuria (PRO) and aseptic leukocyturia (LEU) were further analyzed using multiple logistic regression.</p> <p>Results</p> <p>Median age of the patients in the study (N = 300) was 40 years, 70.3% were female and 71.7% were on highly active antiretroviral therapy. Using the MDRD method, CKD prevalence in patients was 45.7%, 30.2% of whom being classified as stage 1 according to the NKF classification, 13.5% as stage 2 and 2% as stage 3. No patient was classified as stage 4 or 5. Among CKD patients with urinary abnormality, PRO accounted for 6.1% and LEU for 18.4%. Significant associations were found between LEU and non-steroidal anti-inflammatory drug (NSAID) use, previous history of tuberculosis, low body mass index and female gender and between PRO and high viral load.</p> <p>Conclusion</p> <p>Our study, using a very sensitive definition for CKD evaluation, suggests a potentially high prevalence of CKD among PLWHA in Burundi. Patients should be regularly monitored and preventative measures implemented, such as monitoring NSAID use and adjustment of drug dosages according to body weight. Urine dipsticks could be used as a screening tool to detect patients at risk of renal impairment.</p

Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria

<p>Abstract</p> <p>Background</p> <p>Malaria during pregnancy is a major public health problem in Nigeria leading to increase in the risk of maternal mortality, low birth weight and infant mortality. This paper is aimed at highlighting key predictors of the ownership of insecticide treated nets (ITNs) and its use among pregnant women in Nigeria.</p> <p>Methods</p> <p>A total of 2348 pregnant women were selected by a multi-stage probability sampling technique. Structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behaviour and practices. Logistic regression was used to detect predictors of two indicators: ITN ownership, and ITN use in pregnancy among those who owned ITNs.</p> <p>Results</p> <p>ITN ownership was low; only 28.8% owned ITNs. Key predictors of ITN ownership included women who knew that ITNs prevent malaria (OR = 3.85; <it>p </it>< 0001); and registration at antenatal clinics (OR = 1.34; <it>p </it>= 0.003). The use of ITNs was equally low with only 7.5% of all pregnant women, and 25.7% of all pregnant women who owned ITNs sleeping under a net. The predictors of ITN use in pregnancy among women who owned ITNs (N = 677) identified by logistic regression were: urban residence (OR = 1.87; <it>p </it>= 0.001); knowledge that ITNs prevent malaria (OR = 2.93; <it>p </it>< 0001) and not holding misconceptions about malaria prevention (OR = 1.56; <it>p </it>= 0.036). Educational level was not significantly related to any of the two outcome variables. Although registration at ANC is significantly associated with ownership of a bednet (perhaps through free ITN distribution) this does not translate to significant use of ITNs.</p> <p>Conclusions</p> <p>ITN use lagged well behind ITN ownership. This seems to suggest that the current mass distribution of ITNs at antenatal facilities and community levels may not necessarily lead to use unless it is accompanied by behaviour change interventions that address the community level perceptions, misconceptions and positively position ITN as an effective prevention device to prevent malaria</p

"Opening locked doors": evaluating peer education in schools in the Western Cape province: a mixed methods longitudinal study

Final draft report submitted to the Centre for Peer Education, Health and Education Training and Technical Assistance Services (HETTAS), 14 FebruaryPeer education has long been seen as a key health promotion strategy and important mechanism to challenge and shift youth behavioural norms, especially for those issues not easily discussed between adults and youth. Deutsch and Swartz, (2002, p. 37) have described how peer education achieves this though providing a safe place for candid and genuine examination of attitudes, choices, and situations. Over many years of programme implementation, globally and in South Africa, empirical evidence regarding its efficacy has been difficult to obtain. At best peer education programmes have been shown to aid peer educators in a number of important ways but evidence for change in those who take part as peer learners has been elusive. This report provides an evaluation of a peer education intervention funded1 by The Global Fund To Fight AIDS, Tuberculosis and Malaria (The Global Fund), and implemented by the Western Cape Department of Health and Western Cape Department of Basic Education in collaboration with various NGOs (known as implementing organisations) along with technical assistance and monitoring provided by the Centre for the Support of Peer Education (CSPE). Fundamentally the study asked what doors do peer education open that are not usually opened in the course of teacher-led educational interventions. This study answers this question by showing how this peer education programme in particular has opened doors regarding increased levels of knowledge and discussion amongst youth, improved measures of self-efficacy regarding sexual decision making and heightened sensitivities amongst young people regarding their need for help and support